HomeMy WebLinkAboutPermit Electrical 2005-7-25
.
. CITY OF SPRINGFIELD '
Building/Combination Permit
PERMIT NO: COM2005-00964
ISSUED: 07/25/2005
APPLIED: 07/2512005
EXPIRES: 01125/2006
VALUE:
Status: Issued
~ 225 Fifth Street, Springfield, OR
, 541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1250 Rainbow Dr
ASSESSOR'S PARCEL NO.: 1703273402602
Springfield TYPE OF
Electrical Work Only
TYPE OF USE: Addition
Residential
PROJECT DESCRIPTION: Electrical Only, Power Pedestal
Owner: RAINBOW VILLAGE INC
Address: 1250 RAINBOW DRNE
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION.
, Contractor Type
Electrical
Contractor
TONY KOTH
License
59748
I BUILDING INFORMATIONI
Expiration Date
05/04/2006
Phone
541-688-8996
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Yrimary Construction Type
Secondary Construction
# of Bedrooms:
# of Stories: Lot Size:
Height of.. S~ !!2q~tt!"I.O:or~K
Typeof1fe~t::',t.'::,. f>-ll t.y.,I'I\'S~ F;\.~~~ f!or.r::l
Water, Type'\L l,c\'\I,'\I\ s\\ Ul" i\-\I~Sq\FtBasement:
,t, v l.. UN "'Ir" rV<1
Range TYP,e,:, \ \llhIL\:O 'IS t\\3A\~!iIFt Garage/Carport
Energy Path: t 'l''''tU 0\-\ Sq FtOther:
CO'I'\ {W"'ll\)
Sprinkled '" lJt\~ PlnJa ' Occupant Load:
,,," 1~\J
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
'; Rearyard Setback:
Solar Setbacks:
Overlay D1st:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
IPUBLIC IMPRv ~ ",n"" TSI
Street 'reS yOU to
. Oregon laW reqU\ UtIlity
Storm Sewer A vaila'l!~O~. ted by the Oregon t 10rtl'1
Special Instruction: ""'ilGO rulGSl!ldOP 'Tl'1ose rules are se2 001,
w canter. 1'1 Op.,f', 95 .
Notes: \i.\otm~~$1..o010tl'1rO~~s oH\'16 rules by
tn ~ \l'n<. YrB1 obtain, ~~~o. 1M telephOne_
"",OCi1\n9~Cillru"...I-- \II"Y \;2.:.... -......
~...w.:!l ~ \he ore$C\9 ~blltinMDescriDtion I
\ll.lIo"--'l!;;0nter \l'l1..f.- '
T f C t t. S Per Sq Ft Square Footage
vpe 0 ons rue IOn Iti n Bid Am t
ormu p er or oun
Sidewalk Type:
DownspoutslDrains
Description
Value
Date Calculated
1 of 2
.
.
CITY OF SPRINljN~LD
Status: Issued
225 Flfth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Building/Combination Permit
PERMIT NO: COM2005-00964
ISSUED: 07/25/2005
APPLIED: 07/25/2005
EXPIRES: 0112512006
VALUE:
Total Value of Project
Fp.p.s Paid I
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Perm ServlFdr 200 amps or less
Amount Paid
$6.30
54.41
$63.00
Date Paid
7/25/05
7/25/05
7/25/05
Receipt Number
1200500000000001067
1200500000000001067
1200500000000001067
Total Amount
$73.71
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
Electric Service: Approval required prior to utility company energizing service.
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein,
and that NO OCCUPANCY wID be made of any structure without permissinn of the Community Services Division,
Building Safety. I further certify that only contractors and employees who are In compliance with ORS 701.005 will be used
on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address Is readable from
the street, that the permit card is located at the front of the property, and the apprnvcd set of plans wID remain on the site
at all times during construction.
Owner or Contractors Signature
Date
2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00964
COM2005-00964
COM2005-00964
Payments:
Tlpe of Payment
Check
.,
7/25/2005
.
RECEIPT #:
7'~INQ:"~ --- i,
WiL - ,
,
" .I
. "--"-_.
~ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200500000000001067
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Penn Serv/Fdr 200 amps or less
Paid By
LITE ELECTRIC
Received By
djb
1 of I
Date: 07/25/2005
Item Tolal:
l:beck Number Aulborization
Batch Number Number How Received
6824 In Person
Payment Total:
1:31:42PM
Amoont Due
4.41
6,30
63,00
$73.71
Amoun! Paid
$73,71
$73.71